CHANGES could be made to maternity services in Somerset to provide pregnant women with greater choice.

Health trusts in Somerset and Wiltshire are working together to transform the way services are delivered for people in the catchment area of the Royal United Hospital (RUH) in Bath.

The head of the transformation project said that existing midwifery units in the catchment were “under-utilised”, and that new measures may be brought in to better reflect the needs of pregnant women in the area.

The precise details of possible changes will be finalised over the summer, and will go out to a formal public consultation at the end of September.

The project is being led by Lucy Baker, acting director of acute commissioning for the Wiltshire Clinical Commissioning Group (CCG), which decides where NHS funding can be allocated in a given area.

She laid out the current picture of the service to members of Somerset County Council’s adults and health scrutiny committee, which met in Taunton on Wednesday morning (June 6).

She said: “We have no safety concerns about our services – we just want to make them as good as possible.

“This piece of work is not about saving money – this piece of work is about delivering cost-neutral change.“ She added that the project was designed to “future-proof the system up to 2030”, taking into account women who are “bigger” or choose to have children later in life.

Around £400,000 has been provided from the national NHS budget for this project under the government ‘Better Birth’ initiative.

Any savings which are generated from restructuring “will be reinvested” in maternity services, Ms Baker pledged.

One of the changes which could be introduced is the provision of an “alongside birthing unit” at RUH, along the lines of the facility currently in place at the Great Western Hospital in Swindon.

This unit would be led by midwives as “a low-clinical environment”, intended to make the experience of giving birth as relaxing and comfortable as possible.

If there are complications or other issues with the birth, the mother can be moved straight through into the main hospital for treatment, rather than having to endure an ambulance ride from her home or one of the designated maternity units in the area.

Ms Baker said that 2,000 people from Bath and North East Somerset (BANES), Swindon and Wiltshire had been consulted on this matter, with a large proportion wanting such a facility in Bath.

The RUH Bath NHS Foundation Trust currently has four free-standing midwifery units, based in Chippenham, Frome, Paulton and Trowbridge.

These units between them deliver 38 babies per month – a level which Councillor Tessa Munt branded as “completely unsustainable”.

When pushed over whether any of these four units would be closing, Ms Baker stressed that no decisions had been taken and options were still being discussed ahead of the public consultation.

She said: “There may be a change for the local population – but we are not at that stage yet”.

Ms Baker has also suggested that pregnancy records could be digitalised to ensure better communication between midwifery and early years provision, allowing stuff to flag up issues earlier.

She admitted that there was “a tsunami of retirement coming” in midwifery (a large number of current personnel coming up to retirement age) – but added that the trust was managing to recruit new staff and was meeting the NHS target of one midwife for every 29.5 births.

She said: “If we deliver the model that’s right for women, and the model that the staff want, it will help our recruitment and help us to keep the staff we want.”

Councillor Andrew Govier raised concerns about encouraging women to have home births, stating that it could put pressure on midwives.

He said: “If a midwife is out dealing with a lady in the community, she’s not able to see someone in the next ward over.”

Ms Baker said that more time should be given to midwives to lay out choices and assess each woman’s complexity, to decide whether a home birth was the best option.

She added that a “home birth hub” of dedicated midwives could be created, reflecting the expensive and “resource-intensive” nature of home births, and more work would be done to ensure that women would continue seeing the same midwife throughout their pregnancy.

Once the options for the service have been finalised, a formal public consultation will be held between September 27 and December 19.

A report detailing these options will come back before the scrutiny committee on or before September 5, ahead of the consultation beginning.

Any changes will be introduced to the RUH catchment area from May 2019.

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